Reading material on improving patient communication

The language used to describe people with intellectual disabilities varies from country to country, culture and society to society and is constantly evolving. Currently, terms such as mental retardation, mental retardation, oligophrenia or delayed mental development. “retarded”, “special needs”, “disease”, “handicapped”, or “mentally handicapped” is considered stigmatizing and evaluative, and “person with intellectual disability” is considered the correct form. When talking about people with intellectual disabilities and addressing people with intellectual disabilities, you should be very sensitive and use language that emphasizes the value of all people as full members of our common society. If you are dealing with an adult and you are not in a close relationship, you should use the courtesy form “Madam, sir”, even if this person addresses you by name. If you know each other well and are in a closer relationship, of course you can use the first name or warmer forms if both of you are comfortable to do so. In the first place, always address the person with intellectual disability directly, respecting their autonomy, and not their caregiver.  

In contact with a person with an intellectual disability, you must show special empathy. In this group, apart from limitations in intellectual functioning, there are also limitations in adaptive behaviour in terms of conceptual, social and practical skills used in everyday life. People with intellectual disabilities may have problems with communication, interpersonal relationships, compliance with rules and laws, and responsibility for their conduct. More common are problems in understanding or producing speech and language or in using language for communication purposes, Sometimes special boards, drawings or pictograms are helpful in communication (ALTERNATIVE COMMUNICATION- Additionally available in the e-manual). Older adults with impaired intellectual development may experience a faster onset of dementia or a decrease in skill compared to the general population. Remember that if a person with an intellectual disability doesn’t make eye contact with you or doesn’t respond to your words, it doesn’t mean they don’t listen to you or ignore you. You need to be very patient, often people with intellectual disabilities need more time to understand what is expected of them and make certain decisions, but this does not mean that they cannot do it.  

Communication difficulties will depend largely on the degree of intellectual disability.  

In general, people with mild disabilities are able to communicate fluently, including about past, present and future events.  Most are able to communicate their decisions about future goals, healthcare, and relationships (e.g., who and how they prefer to spend their time). Most can also follow and follow instructions of up to 3 steps. 

People with moderate intellectual disabilities are mostly able to communicate in short sentences and communicate their preferences for future goals, health care and relationships, but they will not always act on their declarations. Most can follow instructions consisting of up to two steps, so you must use short and simple commands when describing individual fitness tests. 

Most people with severe intellectual disabilities are able to use communication strategies to indicate their preferences, including those regarding future goals, health care, and relationships for specific choices. Visual aids can be useful in communication. Most people in this group can follow the one-step instructions and stop the activity on demand. 

People with profound intellectual disabilities are mostly able to convey information about their basic needs and preferences using nonverbal strategies and single words. For the most part, they can perform very simple tasks using hints and help. 

The overall incidence of impaired intellectual development is somewhat higher in men. In some societies, reduced social value and expectations towards women compared to men can negatively affect the accurate diagnosis and provision of adequate support to women with intellectual disabilities. This makes it more difficult for them to achieve and show their range of possibilities. Men and women also differ in the prevalence of certain behaviours and mental, behavioural or neurodevelopmental disorders. Men are more likely to show hyperactivity and behavioural disorders, while women are more likely to show mood disorders and increased anxiety (also of new situations, challenges, physical activity).